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DR. XIANDONG SHI M.D.
NPI 1316124795
Internal Medicine in Flushing, NY

Active since January 28, 2008PECOS EnrolledAccepts Medicare AssignmentCLIA 33D2028129 · Waiver
4160 MAIN ST UNIT 312, FLUSHING, NY 11355(718) 865-8648(718) 799-1019 Get Directions Write a Review

NPPES record last updated: September 4, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Xiandong Shi M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. XIANDONG SHI M.D. (NPI 1316124795) is an individual internal medicine provider in Flushing, New York, licensed in New York (247287) and active in the NPI registry since January 2008. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through August 8, 2027, and is a graduate of Other (1983).

NPPES Registry Identity

NPI1316124795
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. XIANDONG SHICredential: M.D.
Location Address4160 MAIN ST UNIT 312Flushing, NY 11355-3833
Mailing Address41-60 Main Street, Suit 312Flushing, NY 11355 · (718) 864-8648 · Fax (718) 799-1019
Phone(718) 865-8648
Fax(718) 799-1019
Sole ProprietorYes
Medical School CMSOtherGraduated 1983
Enumeration DateJanuary 28, 2008
Last NPPES UpdateSeptember 4, 2015
✔ NPI 1316124795 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NY · 247287
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
4160 MAIN ST UNIT 312, Flushing, NY 11355
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Xiandong Shi M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5395814917
PECOS Enrollment IDI20080521000696
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D2028129

Xiandong Shi, MD · Flushing, NY
Active · expires Aug 8, 2027
CLIA Number33D2028129
Laboratory TypePhysician Office
Certificate Effective DateAugust 9, 2025
Certificate Expiration DateAugust 8, 2027
Laboratory DirectorDr. Xiandong Shi
Laboratory Phone(718) 865-8648
Laboratory LocationXiandong Shi, MD41-60 Main Street, Unit 201C, Flushing, NY 11355
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
160 services44 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
16 services11 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11355 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$153.13 typical visit price
range $67.00 – $201.98
Typical copayment $38.28 (range $16.75 – $50.49)
Most-billed visit code 99204
Established Patient
$116.96 typical visit price
range $21.62 – $163.52
Typical copayment $29.24 (range $5.40 – $40.88)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Xiandong Shi's NPI number?

The NPI number for Xiandong Shi is 1316124795. It was assigned to this individual provider in the NPPES registry on January 28, 2008.

Where is Xiandong Shi located?

Xiandong Shi practices at 4160 Main St Unit 312, Flushing, NY 11355. The listed phone number is (718) 865-8648.

What is Xiandong Shi's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Xiandong Shi enrolled in Medicare?

Yes. Xiandong Shi is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Does Xiandong Shi hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2028129) is associated with this NPI, valid through August 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Xiandong Shi was last updated on September 4, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.